LEXINGTON, Ky. — Working as a labor and delivery nurse for a decade, Kristin Ashford was surrounded by happy beginnings.

Video produced by Alicia Gregory of REVEAL Research Media. 

She helped women and families welcome healthy babies into the world.

But amid those happy and healthy beginnings, Ashford also helped mothers and their families work through the stressful and heart-wrenching experience of pre-term birth. As a first-hand witness of the adverse outcomes associated with pre-term birth, Ashford was motivated to make a difference in this area of health care. She transitioned into a career researching risk factors of pre-term birth and creating strategies to prevent these negative outcomes through pregnancy interventions.

“It really got me interested in how to help these women more,” Ashford said of her nursing experience in labor and delivery. “Not only to reduce their risk, but also to help them emotionally cope with pre-term birth.”

As the assistant dean of research in the UK College of Nursing, Ashford implements multiple research projects and interventions bound by the common goal of prolonging pregnancy. Several risk factors, including smoking, substance abuse, poor socioeconomic conditions and obesity, increase a woman’s chance of experiencing pre-term birth, which is defined as delivery prior to 37 weeks gestation. Consequences of pre-term birth include respiratory illness, gastrointestinal disorders, immune deficiency, hearing, and vision problems, and a prolonged hospital stay, as well as longer-term motor, cognitive, visual, hearing, behavioral, social-emotional, health and growth problems.

Because there are many modifiable behaviors and genetic factors associated with pre-term birth, Ashford’s research spans a spectrum of issues relevant to pre-natal care. Her interventions aim to prevent tobacco and illicit drug use, manage chronic conditions such as diabetes and obesity, and reduce emotional distress in expectant mothers.

“I think that any time that you can prolong a pregnancy, it is a rewarding experience,” she said. “If you can prevent the child from being sick, prevent that family’s stress and prevent life-long complications associated with that risk, that's extremely rewarding.”

Ashford’s interventions are founded on the CenteringPregnancy model, which prepares women for pregnancy, labor and delivery, and motherhood through a peer support groups led by nursing and other health professionals. Ashford has designed CenteringPregnancy interventions to help pregnant women in high-risk categories, including diabetes, tobacco use, substance abuse, or other socioeconomic or ethnic risk factors.

“Our UK program actually wants to put women together that have more in common with one another,” Ashford said. “So, in addition to being put in the group about the same time that they're pregnant, they also are put in (a group) based on their most high-risk factor for pre-term birth.”

One intervention effort led by Ashford effort seeks to inform pregnant women about the dangers of using tobacco products while pregnant and give them resources to quit. Despite the known risks of using tobacco products during pregnancy, many pregnant women in Kentucky still smoke. Ashford is troubled by the rising popularity of e-cigarettes among women of childbearing age. Her research studies indicate that women are using both e-cigarettes and traditional tobacco products during pregnancy.

“Tobacco causes birth defects in pregnancy — that's known,” Ashford said. “And so, it's very clear that electronic cigarettes contain tobacco. Certainly, there's risks associated with electronic cigarette use in pregnancy.”

Ashford is expanding CenteringPregnancy programs to areas in Eastern and Western Kentucky. She is working with local health departments to provide a Centering support network for pregnant women in high-risk groups. She said her position in the UK College of Nursing allows her to research and disseminate interventions, teach future nurses and nursing researchers, and serve communities by improving the quality of health care.

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